Author Question: A patient who has breast cancer has been taking toremifene for 2 weeks. She tells her primary care ... (Read 51 times)

shofmannx20 · **on:** Jul 24, 2018

A patient who has breast cancer has been taking toremifene for 2 weeks. She tells her primary care NP that she thinks her tumor has grown larger. The NP should:

a. schedule her for a breast ultrasound.
b. reassure her that this is common and will subside.
c. tell her she may need an increased dose of this medication.
d. contact her oncologist to discuss adding another medication.

Question 2

A patient is newly diagnosed with Alzheimer's disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:

a. donepezil (Aricept).
b. rivastigmine (Exelon).
c. memantine (Namenda).
d. galantamine (Razadyne).

Jane · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
Toremifene can cause tumor flare in the first few weeks of therapy, but the tumor later regresses. An ultrasound is unnecessary at this stage. The NP does not need to notify the oncologist unless this continues to worsen.

Answer to Question 2

C
Patients with moderate to severe dementia (stages 5 to 7) may be started on memantine.